OBJECTIVES: To determine if the ratio of positive to negative lymph nodes, or lymph node ratio (LNR), is a prognostic variable in patients with node-positive endometrial cancer and the impact of adjuvant therapy on survival. METHODS: After institutional review board approval, a retrospective review of patients diagnosed as having stage IIIC endometrioid or mixed endometrioid endometrial cancer at a single institution from January 2000 through October 2011 was performed. Clinicopathologic and adjuvant treatment data were collected. Univariate and multivariate analysis were used to identify prognostic factors for progression-free (PFS) and overall survival. RESULTS: One hundred twenty-four patients with stage IIIC1 (n = 64) and IIIC2 (n = 60) endometrial cancer were included in the analysis. Median age was 60 years (range, 25-84 years), and median follow-up was 49.4 months (range, 0.1-301.6 months). Age >70 years was identified as a prognostic factor for worse PFS (P = 0.0002) and overall survival (P = 0.0002) on multivariate analysis. Patients in this cohort receiving any adjuvant radiotherapy showed improved PFS (hazard ratio [HR], 0.34; 95% CI, 0.13-0.90; P = 0.03) compared with those receiving any adjuvant chemotherapy (HR, 2.33; 95% CI, 1.16-4.65; P = 0.02). In a subgroup analysis, patients with at least 10 nodes removed (n = 81) with an LNR greater than 50% had a PFS of 25.2 months compared with 135.6 months with an LNR of 50% or less (HR, 3.87; 95% CI, 1.15-13.04; P = 0.03). CONCLUSIONS: Lymph node ratio may define a subgroup of stage IIIC endometrial cancers at increased risk for recurrence. Adjuvant radiotherapy was associated with decreased recurrence risk.
OBJECTIVES: To determine if the ratio of positive to negative lymph nodes, or lymph node ratio (LNR), is a prognostic variable in patients with node-positive endometrial cancer and the impact of adjuvant therapy on survival. METHODS: After institutional review board approval, a retrospective review of patients diagnosed as having stage IIIC endometrioid or mixed endometrioid endometrial cancer at a single institution from January 2000 through October 2011 was performed. Clinicopathologic and adjuvant treatment data were collected. Univariate and multivariate analysis were used to identify prognostic factors for progression-free (PFS) and overall survival. RESULTS: One hundred twenty-four patients with stage IIIC1 (n = 64) and IIIC2 (n = 60) endometrial cancer were included in the analysis. Median age was 60 years (range, 25-84 years), and median follow-up was 49.4 months (range, 0.1-301.6 months). Age >70 years was identified as a prognostic factor for worse PFS (P = 0.0002) and overall survival (P = 0.0002) on multivariate analysis. Patients in this cohort receiving any adjuvant radiotherapy showed improved PFS (hazard ratio [HR], 0.34; 95% CI, 0.13-0.90; P = 0.03) compared with those receiving any adjuvant chemotherapy (HR, 2.33; 95% CI, 1.16-4.65; P = 0.02). In a subgroup analysis, patients with at least 10 nodes removed (n = 81) with an LNR greater than 50% had a PFS of 25.2 months compared with 135.6 months with an LNR of 50% or less (HR, 3.87; 95% CI, 1.15-13.04; P = 0.03). CONCLUSIONS: Lymph node ratio may define a subgroup of stage IIIC endometrial cancers at increased risk for recurrence. Adjuvant radiotherapy was associated with decreased recurrence risk.
Authors: Wendy A Woodward; Vincent Vinh-Hung; Naoto T Ueno; Yee Chung Cheng; Melanie Royce; Patricia Tai; Georges Vlastos; Anne Marie Wallace; Gabriel N Hortobagyi; Yago Nieto Journal: J Clin Oncol Date: 2006-06-20 Impact factor: 44.544
Authors: Angeles Alvarez Secord; Laura J Havrilesky; David M O'Malley; Victoria Bae-Jump; Nicole D Fleming; Gloria Broadwater; David E Cohn; Paola A Gehrig Journal: Gynecol Oncol Date: 2009-06-26 Impact factor: 5.482
Authors: Janiel M Cragun; Laura J Havrilesky; Brian Calingaert; Ingrid Synan; Angeles Alvarez Secord; John T Soper; Daniel L Clarke-Pearson; Andrew Berchuck Journal: J Clin Oncol Date: 2005-02-28 Impact factor: 44.544
Authors: T E Le Voyer; E R Sigurdson; A L Hanlon; R J Mayer; J S Macdonald; P J Catalano; D G Haller Journal: J Clin Oncol Date: 2003-08-01 Impact factor: 44.544
Authors: Ugwuji N Maduekwe; Gregory Y Lauwers; Carlos Fernandez-Del-Castillo; David L Berger; Charles M Ferguson; David W Rattner; Sam S Yoon Journal: Ann Surg Oncol Date: 2010-01-23 Impact factor: 5.344
Authors: Nicole Concin; Carien L Creutzberg; Ignace Vergote; David Cibula; Mansoor Raza Mirza; Simone Marnitz; Jonathan A Ledermann; Tjalling Bosse; Cyrus Chargari; Anna Fagotti; Christina Fotopoulou; Antonio González-Martín; Sigurd F Lax; Domenica Lorusso; Christian Marth; Philippe Morice; Remi A Nout; Dearbhaile E O'Donnell; Denis Querleu; Maria Rosaria Raspollini; Jalid Sehouli; Alina E Sturdza; Alexandra Taylor; Anneke M Westermann; Pauline Wimberger; Nicoletta Colombo; François Planchamp; Xavier Matias-Guiu Journal: Virchows Arch Date: 2021-02 Impact factor: 4.064
Authors: Jvan Casarin; Francesco Multinu; Nadeem Abu-Rustum; David Cibula; William A Cliby; Fabio Ghezzi; Mario Leitao; Ikuo Konishi; Joo-Hyun Nam; Denis Querleu; Pamela T Soliman; Kathleen J Yost; Amy L Weaver; Andrea Mariani; Gretchen E Glaser Journal: Int J Gynecol Cancer Date: 2019-01 Impact factor: 3.437